Novartis Pharmaceuticals Corp v. West-Ward Pharmaceuticals , 923 F.3d 1051 ( 2019 )


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  •   United States Court of Appeals
    for the Federal Circuit
    ______________________
    NOVARTIS PHARMACEUTICALS CORPORATION,
    NOVARTIS AG,
    Plaintiffs-Appellees
    v.
    WEST-WARD PHARMACEUTICALS
    INTERNATIONAL LIMITED,
    Defendant-Appellant
    ______________________
    2018-1434
    ______________________
    Appeal from the United States District Court for the
    District of Delaware in No. 1:15-cv-00474-RGA, Judge
    Richard G. Andrews.
    ______________________
    Decided: May 13, 2019
    ______________________
    CHRISTINA A. L. SCHWARZ, Venable LLP, New York,
    NY, argued for plaintiffs-appellees. Also represented by
    NICHOLAS N. KALLAS, SHANNON KEOUGH CLARK, LAURA
    KATHERINE FISHWICK, SUSANNE FLANDERS, JARED LEVI
    STRINGHAM.
    DAVID ZIMMER, Goodwin Procter LLP, Boston, MA, ar-
    gued for defendant-appellant. Also represented by KEITH
    A. ZULLOW, CINDY CHANG, STEVEN J. BERNSTEIN, MICHAEL
    2                       NOVARTIS PHARM. v. WEST-WARD PHARM.
    B. COTTLER, New York, NY; NATASHA ELISE DAUGHTREY,
    Los Angeles, CA; WILLIAM M. JAY, Washington, DC.
    ______________________
    Before STOLL, PLAGER, and CLEVENGER, Circuit Judges.
    STOLL, Circuit Judge.
    West-Ward Pharmaceuticals International Ltd (“West-
    Ward”) 1 appeals the decision of the United States District
    Court for the District of Delaware holding that claims 1–3
    of 
    U.S. Patent No. 8,410,131
     would not have been obvious
    in view of the prior art. We conclude that the district court
    did not err in its nonobviousness determination and affirm.
    BACKGROUND
    Novartis Pharmaceuticals Corp. and Novartis AG (col-
    lectively, “Novartis”) own the ’131 patent, which claims
    methods of using the compound everolimus to treat ad-
    vanced renal cell carcinoma (“RCC”). Everolimus is the ac-
    tive ingredient in Novartis’s Afinitor product. West-Ward’s
    predecessor in interest filed an Abbreviated New Drug Ap-
    plication (“ANDA”) seeking to manufacture and sell generic
    versions of Afinitor, and Novartis filed this patent infringe-
    ment suit in response. After a bench trial, the district court
    ruled that West-Ward failed to prove by clear and convinc-
    ing evidence that claims 1–3 of the ’131 patent are invalid
    as obvious. Novartis Pharm. Corp. v. West-Ward Pharm.
    Int’l Ltd., 
    287 F. Supp. 3d 505
    , 518 (D. Del. 2017) (“Deci-
    sion”). West-Ward appeals the district court’s nonobvious-
    ness ruling.
    1On January 9, 2019, appellant West-Ward filed an
    amended certificate of interest notifying this court that it
    is now known as Hikma Pharmaceuticals International
    Ltd. We refer to appellant as West-Ward in this opinion.
    NOVARTIS PHARM. v. WEST-WARD PHARM.                         3
    I. Advanced RCC and the ’131 Patent
    Advanced RCC is a cancer of the kidneys that has
    spread to other parts of the body. As of February 19,
    2001—the priority date of the ’131 patent—advanced RCC
    carried a poor prognosis and was known to be unpredicta-
    ble and difficult to treat. At that time, the only FDA-
    approved drug for treating advanced RCC was the im-
    munostimulant interleukin-2, which was associated with
    poor response rates and toxicity in patients. Interferon al-
    pha, another immunostimulant, was also administered to
    some patients in practice and was likewise shown to have
    poor response rates and toxicity. Numerous clinical trials
    investigating a wide range of treatment strategies for ad-
    vanced RCC failed. Various chemotherapies, hormonal
    therapies, and immunotherapies had been unsuccessful.
    The prior art explained that “[a]dvanced RCC is character-
    ized by a high level of resistance to all treatment modalities
    that have been studied.” J.A. 2058. Cancer drugs in gen-
    eral had high failure rates for treatment of advanced RCC
    in clinical trials, with more than 70% of cancer drugs fail-
    ing during phase II, and a majority of cancer drugs failing
    during phase III.
    The ’131 patent covers methods of administering the
    compound everolimus to inhibit the growth of advanced
    RCC tumors. Claims 1–3 are at issue here. Everolimus is
    recited in claim 1 as formula I:
    1. A method for inhibiting growth of solid excretory
    system tumors in a subject, said method consisting
    of administering to said subject a therapeutically
    effective amount of a compound of formula I
    4                      NOVARTIS PHARM. v. WEST-WARD PHARM.
    wherein
    R1 is CH3,
    R2 is —CH2—CH2—OH, and
    X is —O.
    2. The method of claim 1 wherein the solid excre-
    tory system tumor is an advanced solid excretory
    system tumor.
    3. The method of claim 1 wherein the solid excre-
    tory system tumor is a kidney tumor.
    ’131 patent col. 17 l. 43–col. 18 l. 29 (as amended by Certif-
    icate of Correction).
    II. mTOR Inhibitors
    Everolimus belongs to a class of compounds called
    mTOR inhibitors. These compounds bind intracellularly to
    and form a complex with the FK506 binding protein
    (“FKBP-12”). This complex then binds to and inhibits the
    NOVARTIS PHARM. v. WEST-WARD PHARM.                        5
    activity of the mammalian target of rapamycin (mTOR) en-
    zyme. By February 2001, the prior art disclosed that
    (1) compounds called mTOR inhibitors produced effects,
    such as inhibition of hypoxia-inducible factor 1 (“HIF-1”),
    that were hypothesized to inhibit tumor growth; (2) evero-
    limus was an mTOR inhibitor; and (3) temsirolimus, an-
    other mTOR inhibitor, had shown responses in RCC
    patients in phase I clinical trials. There was no data on the
    efficacy of everolimus to treat any type of cancer, let alone
    to treat advanced RCC.
    At the time of the priority date of the ’131 patent,
    mTOR inhibitors were known in the art to have a variety
    of beneficial properties. Rapamycin, the first mTOR inhib-
    itor, was known to have antimicrobial, immunosuppres-
    sive, and antitumor activities. Its poor solubility, however,
    precluded its development as an anti-cancer agent.
    Temsirolimus, another mTOR inhibitor and a derivative of
    rapamycin, was also known to exhibit antitumor proper-
    ties. Temsirolimus showed improved solubility over ra-
    pamycin and demonstrated positive responses as an anti-
    cancer agent in phase I clinical trials. Everolimus is struc-
    turally similar to temsirolimus and is likewise a derivative
    of rapamycin.
    It was also known in the prior art that advanced RCC
    tumors are highly vascularized and require angiogenesis to
    grow. Angiogenesis is the process through which new blood
    vessels are formed. A prior art article written by Semenza 2
    explained that primary tumors and metastases will not
    grow beyond a certain size without establishing an ade-
    quate blood supply. See J.A. 2113. By February 2001,
    studies showed that tumor angiogenesis correlates with
    2   Gregg L. Semenza, Hypoxia, Clonal Selection, and
    the Role of HIF-1 in Tumor Progression, 35 Critical Revs.
    in Biochemistry & Molecular Biology 71, 71–103 (2000).
    6                     NOVARTIS PHARM. v. WEST-WARD PHARM.
    increased expression of vascular endothelial growth factor
    (“VEGF”) and that, in turn, elevated VEGF expression cor-
    relates with increased expression of HIF-1. See J.A. 2114,
    2118–19. The prior art Zhong 1999 3 study reported ele-
    vated HIF-1 expression in several types of tumor samples,
    including in two RCC tumor samples. See J.A. 2187. By
    the time of the priority date of the patent-in-suit, however,
    HIF-1’s precise mechanism of action and role in tumor
    growth were not yet fully understood. Semenza’s Figure 4
    disclosed that multiple genes (p53, PTEN, VHL), multiple
    pathways (RTKs, RAS, PI3K-AKT-FRAP, RAF-MEK-
    ERK), and multiple downstream effects (relating to VEGF,
    IGF-2, and glucose transporters) are associated with HIF-
    1 expression. See J.A. 2128. While Semenza noted that
    “[i]t is possible that inhibition of HIF-1 activity may con-
    tribute significantly” to the anti-cancer effects of certain
    HIF-1 inhibitors, including rapamycin, it cautioned that
    the role of HIF-1 in RCC “requires further analysis.”
    J.A. 2119, 2127.
    The prior art also provided some evidence linking HIF-
    1 inhibition to mTOR activity, though the exact mechanism
    of action was not established. The prior art Zhong 2000 4
    study investigated the effects of modulating or modifying
    the mTOR pathway (referred to as the FRAP pathway) in
    human prostate cancer cell lines. The study reported that
    treating cells with the mTOR inhibitor rapamycin
    3   Hua Zhong et al., Overexpression of Hypoxia-induc-
    ible Factor 1α in Common Human Cancers and Their Me-
    tastases, 59 Cancer Res. 5830, 5830–35 (1999).
    4   Hua Zhong et al., Modulation of Hypoxia-inducible
    Factor 1α Expression by the Epidermal Growth Fac-
    tor/Phosphatidylinositol     3-Kinase/PTEN/AKT/FRAP
    Pathway in Human Prostate Cancer Cells: Implications for
    Tumor Angiogenesis and Therapeutics, 60 Cancer Res.
    1541, 1541–45 (2000).
    NOVARTIS PHARM. v. WEST-WARD PHARM.                       7
    inhibited the expression of HIF-1α, the regulated subunit
    of HIF-1. See J.A. 2193. Zhong concluded that “HIF-1α-
    dependent gene transcription . . . and the expression of a
    HIF-1-regulated gene product . . . are modulated by the ac-
    tivity of the PI3K/AKT/[mTOR] pathway in [prostate can-
    cer] cells.” J.A. 2194. Zhong recognized that the effect of
    the mTOR pathway “may provide a basis for therapeutic
    efficacy,” but noted that additional studies are required to
    determine the precise mechanism by which mTOR activity
    modulates the expression of HIF-1α. J.A. 2196; see also
    J.A. 2194.
    III. Asserted Prior Art
    West-Ward argued before the district court that ’131
    patent claims 1–3 would have been obvious over a temsiro-
    limus reference (Hidalgo 2000 5 or Hutchinson 6) and an
    everolimus patent (
    U.S. Patent No. 5,665,772
     or U.S. Pa-
    tent No. 6,004,973), in view of the general knowledge in the
    art. We discuss each reference in turn.
    Hidalgo 2000 discusses the development of rapamycin
    and temsirolimus (referred to as CCI-779) as anti-cancer
    agents and the mechanisms of action underlying rapamy-
    cin’s antitumor activity. The reference explains that block-
    ing mTOR interferes with several intracellular pathways
    (e.g., p70s6k, 4E-BP1/PHAS-1) involved in cell cycle pro-
    gression, which leads to growth arrest in the G1 phase of
    the cell cycle. See J.A. 2030. This interference is reported
    to contribute to rapamycin’s inhibition of cancer cell
    growth. See J.A. 2030. Hidalgo 2000 also includes sum-
    maries of the preliminary results of two phase I
    5    Manuel Hidalgo & Eric K. Rowinsky, The Rapamy-
    cin-sensitive Signal Transduction Pathway as a Target for
    Cancer Therapy, 19 Oncogene 6680, 6680–86 (2000).
    6   Ezzie Hutchinson, CCI-779: A New Targeted Anti-
    cancer Agent, 1 The Lancet 198, 198 (2000).
    8                     NOVARTIS PHARM. v. WEST-WARD PHARM.
    temsirolimus clinical trials. These phase I studies were de-
    signed to determine the maximum tolerated dose of
    temsirolimus in patients with a variety of solid tumors.
    The studies show major tumor responses in RCC and cell
    lung carcinoma patients, and minor tumor responses in pa-
    tients having other tumor types. See J.A. 2031. They do
    not disclose the number of RCC patients involved in the
    studies and do not include any data on everolimus. Hidalgo
    2000 notes that “[t]he fact that [temsirolimus] consistently
    induced tumor regressions at relatively nontoxic doses in
    the phase I studies is particularly noteworthy,” and that
    disease-directed studies of temsirolimus would be initiated
    following completion of the phase I studies. J.A. 2031. It
    also recognized that, while the downstream signaling path-
    ways of temsirolimus were “well characterized,” “a critical
    issue is whether these downstream effects correlate with
    the anti-tumor activity of [temsirolimus], particularly since
    malignant cells can traverse the cell cycle and proliferate
    despite” the effects of mTOR inhibition by rapamycin.
    J.A. 2032. Hidalgo 2000 concludes that temsirolimus “in-
    hibit[s] the proliferation of a broad range of human tumors
    both in vitro and in vivo,” but notes that predicting “which
    tumors will be particularly sensitive to [temsirolimus]” re-
    mains a developmental challenge. J.A. 2032–33.
    Hutchinson discusses the clinical development of
    temsirolimus and reviews the updated results from the
    temsirolimus phase I studies disclosed in Hidalgo 2000. It
    notes that temsirolimus had “shown promise in a series of
    phase I studies.” J.A. 2038. One study observed twenty-
    one patients with advanced solid tumors that were admin-
    istered temsirolimus via intravenous infusion. It reported
    that, out of sixteen observable patients, three with RCC
    had a partial (one) or a minor response (two) to the treat-
    ment. Another study observed 51 patients with advanced
    solid tumors that were administered temsirolimus. It re-
    ported minor responses in three RCC patients. Hutchinson
    NOVARTIS PHARM. v. WEST-WARD PHARM.                          9
    also discloses that two phase II clinical trials investigating
    the use of temsirolimus were then underway, one of which
    was investigating RCC in particular.
    The ’772 patent discloses several rapamycin deriva-
    tives including everolimus, which is referred to as “40-O-
    (2-Hydroxy)ethyl-rapamycin.” ’772 patent col. 2 l. 30. The
    ’772 patent teaches that the disclosed compounds “are par-
    ticularly useful” for treating several conditions, including
    organ transplant rejection, autoimmune diseases, asthma,
    and proliferative disorders such as tumors. 
    Id.
     at col. 3
    l. 22–col. 4 l. 1. It also teaches that the disclosed com-
    pounds bind to macrophilin-12 (another name for FKBP-
    12), meaning that they inhibit mTOR activity. 
    Id.
     at col. 6
    ll. 1–3. It is undisputed that the ’772 patent does not dis-
    close any preclinical or clinical data on the antitumor ac-
    tivity of everolimus. It is also undisputed that the ’772
    patent does not contain an explicit disclosure that everoli-
    mus would be effective in treating advanced RCC.
    The ’973 patent also discloses everolimus, which is re-
    ferred to as “40-O-(2-Hydroxy)ethyl rapamycin” and “com-
    pound X.” ’973 patent col. 2 ll. 9–11. The ’973 patent
    discloses everolimus oral formulations, dosage ranges, and
    formulation techniques. 
    Id.
     at col. 2 l. 25–col. 4 l. 59. It is
    undisputed that the ’973 patent does not contain any pre-
    clinical or clinical data showing any antitumor activity of
    everolimus, and does not disclose that everolimus would be
    effective in treating advanced RCC.
    IV. Procedural History
    The ’131 patent covers Novartis’s Afinitor product.
    West-Ward’s predecessor in interest filed ANDA
    No. 207486, seeking to manufacture and sell generic ver-
    sions of Afinitor. In response, Novartis filed the current
    patent infringement suit. The parties stipulated that
    West-Ward’s ANDA infringes claims 1–3 of the ’131 patent
    and a bench trial proceeded on validity.
    10                    NOVARTIS PHARM. v. WEST-WARD PHARM.
    West-Ward argued that administering a therapeuti-
    cally effective amount of everolimus to treat advanced RCC
    would have been obvious to a person of ordinary skill in the
    art. According to West-Ward, knowledge in the art about
    the molecular biology of advanced RCC, the antitumor ac-
    tivity of mTOR inhibitors, phase I temsirolimus clinical
    trial results, and safe dosing ranges for everolimus, would
    have provided a person of ordinary skill with a reasonable
    expectation of success of effectively treating advanced RCC
    with everolimus. Specifically, West-Ward argued that the
    ’131 claims would have been obvious over either Hidalgo
    2000 or Hutchinson in view of either the ’772 patent or the
    ’973 patent, further in view of the general knowledge in the
    art.
    The district court rejected West-Ward’s arguments. It
    found that West-Ward failed to prove that a person of skill
    in the art would have been motivated to select everolimus.
    The district court recognized that there was a need to find
    an effective treatment for advanced RCC, there was a pref-
    erence for oral treatments, temsirolimus showed promising
    phase I clinical data, and everolimus and temsirolimus
    shared certain properties.       Decision, 287 F. Supp. 3d
    at 515–16. In light of these facts, the district court found
    that a person of ordinary skill “would have been motivated
    to pursue everolimus as one of several potential treatment
    options for advanced solid tumors, including advanced
    RCC.” Id. at 516. Despite this finding, however, the dis-
    trict court continued its analysis of whether there would
    have been a motivation to combine. It criticized West-
    Ward’s expert Dr. Cho for limiting his review of the prior
    art to only mTOR inhibitors and found that “the relevant
    prior art would have included art relating to treatments
    beyond mTOR inhibitors.” Id. at 515. It noted that there
    were a variety of other treatments in development at the
    time of the invention and that the knowledge gaps in the
    molecular biology of advanced RCC would have led a
    NOVARTIS PHARM. v. WEST-WARD PHARM.                        11
    person of ordinary skill to search for art beyond those in-
    volving mTOR modulation. The district court explained
    that Dr. Cho’s narrow review allowed hindsight bias to in-
    form his analysis. Even though the district court found
    that there would have been a motivation to pursue everoli-
    mus, it ultimately determined that West-Ward “failed to
    prove by clear and convincing evidence that a POSA would
    have been motivated to select everolimus.” Id. at 516.
    In addition, the district court determined that the as-
    serted prior art would not have provided a person of ordi-
    nary skill in the art with a reasonable expectation of
    success in using everolimus to treat advanced RCC. Id. It
    noted Dr. Cho’s admission that a person of skill in the art
    would not have reasonably expected a drug to work based
    only on phase I clinical trial results, or on the fact that a
    drug had entered phase II clinical trials. Id. The district
    court explained that the temsirolimus phase I data dis-
    closed in Hutchinson had diminished weight because it re-
    sulted from small sample sizes and because phase I clinical
    trials are designed to determine safety, not efficacy. Id. It
    further noted that everolimus and temsirolimus differed in
    pharmacological properties relevant to treatment. These
    differences, along with the high failure rate of cancer drugs
    in phase II and III clinical trials, and the fact that the mo-
    lecular pathways of advanced RCC were not fully under-
    stood, all diminished the relevance of the temsirolimus
    data. Based on these facts, the district court found that
    West-Ward failed to establish by clear and convincing evi-
    dence that a person of skill in the art would have reasona-
    bly expected everolimus to effectively treat advanced RCC.
    The district court ultimately concluded that West-
    Ward failed to show by clear and convincing evidence that
    claims 1–3 of the ’131 patent are invalid as obvious. West-
    Ward appeals the decision of the district court. We have
    jurisdiction under 
    28 U.S.C. § 1295
    (a)(1).
    12                     NOVARTIS PHARM. v. WEST-WARD PHARM.
    DISCUSSION
    I. Standard of Review
    “Following a bench trial on the issue of obviousness, we
    review the court’s ultimate legal conclusions de novo and
    the underlying factual findings for clear error.” Insite Vi-
    sion Inc. v. Sandoz, Inc., 
    783 F.3d 853
    , 858 (Fed. Cir. 2015)
    (quoting Tyco Healthcare Grp. LP v. Ethicon Endo-Surgery,
    Inc., 
    774 F.3d 968
    , 974 (Fed. Cir. 2014)). “A factual finding
    is clearly erroneous if, despite some supporting evidence,
    we are left with the definite and firm conviction that a mis-
    take has been made.” Ferring B.V. v. Watson Labs., Inc.-
    Fla., 
    764 F.3d 1401
    , 1406 (Fed. Cir. 2014) (citing United
    States v. U.S. Gypsum Co., 
    333 U.S. 364
    , 395 (1948)).
    II. Obviousness
    A patent is invalid “if the differences between the sub-
    ject matter sought to be patented and the prior art are such
    that the subject matter as a whole would have been obvious
    at the time the invention was made” to a person of ordinary
    skill in the art to which said subject matter pertains.
    
    35 U.S.C. § 103
    (a). 7 Obviousness is a question of law based
    on underlying factual determinations including: (1) the
    “level of ordinary skill in the pertinent art,” (2) the “scope
    and content of the prior art,” (3) the “differences between
    the prior art and the claims at issue,” and (4) “secondary
    considerations” of non-obviousness such as “commercial
    success, long-felt but unsolved needs, failure of others, etc.”
    KSR Int’l Co. v. Teleflex Inc., 
    550 U.S. 398
    , 406 (2007)
    7  Because the ’131 patent does not contain any claim
    with an effective filing date on or after March 16, 2013, the
    version of 
    35 U.S.C. § 103
     that applies here is the one pre-
    ceding the changes made by the America Invents Act. See
    Leahy-Smith America Invents Act, Pub. L. No. 112-29, 
    125 Stat. 284
    , 293, § 3(n) (2011).
    NOVARTIS PHARM. v. WEST-WARD PHARM.                       13
    (quoting Graham v. John Deere Co., 
    383 U.S. 1
    , 17–18
    (1966)).
    A party seeking to invalidate a patent based on obvi-
    ousness must prove “by clear and convincing evidence that
    a skilled artisan would have been motivated to combine the
    teachings of the prior art references to achieve the claimed
    invention, and that the skilled artisan would have had a
    reasonable expectation of success in doing so.” Procter &
    Gamble Co. v. Teva Pharm. USA, Inc., 
    566 F.3d 989
    , 994
    (Fed. Cir. 2009) (quoting Pfizer, Inc. v. Apotex, Inc., 
    480 F.3d 1348
    , 1361 (Fed. Cir. 2007)). “The presence or absence
    of a motivation to combine references in an obviousness de-
    termination is a pure question of fact.” PAR Pharm., Inc.
    v. TWI Pharm., Inc., 
    773 F.3d 1186
    , 1196 (Fed. Cir. 2014)
    (quoting Alza Corp. v. Mylan Labs., Inc., 
    464 F.3d 1286
    ,
    1289 (Fed. Cir. 2006)). “The presence or absence of a rea-
    sonable expectation of success is also a question of fact.”
    
    Id.
    We hold that the district court erred in its analysis of
    whether there was a motivation to combine. However, we
    discern no clear error in the district court’s finding that a
    person of ordinary skill would not have reasonably ex-
    pected success in using everolimus to treat advanced RCC
    as of February 2001. We thus agree with the district
    court’s ultimate determination that the challenged claims
    would not have been obvious. We address both prongs of
    the obviousness inquiry below.
    A. Motivation to Combine
    After reviewing the prior art, the district court found
    that a person of ordinary skill “would have been motivated
    to pursue everolimus as one of several potential treatment
    options for advanced solid tumors, including advanced
    RCC.” Decision, 287 F. Supp. 3d at 516. This finding
    should have affirmatively answered whether there would
    have been a motivation to combine. Yet, the district court
    continued its analysis and found that West-Ward “failed to
    14                    NOVARTIS PHARM. v. WEST-WARD PHARM.
    prove by clear and convincing evidence that a POSA would
    have been motivated to select everolimus.” Id. The district
    court erred in applying this heightened standard. “[O]ur
    case law does not require that a particular combination
    must be the preferred, or the most desirable, combination
    described in the prior art in order to provide motivation for
    the current invention.” In re Fulton, 
    391 F.3d 1195
    , 1200
    (Fed. Cir. 2004); see also Bayer Healthcare Pharm., Inc. v.
    Watson Pharm., Inc., 
    713 F.3d 1369
    , 1376 (Fed. Cir. 2013).
    It is thus improper to require West-Ward to prove that a
    person of ordinary skill would have selected everolimus
    over other prior art treatment methods.
    Citing Takeda Chemical Industries, Ltd. v. Alpha-
    pharm Pty., Ltd., 
    492 F.3d 1350
     (Fed. Cir. 2007), Novartis
    argues that the district court did not err in concluding that
    the prior art fails to provide motivation to select everoli-
    mus. See Appellee Br. 58–59. As West-Ward correctly
    notes, however, Takeda is a lead compound case. See Ap-
    pellant Reply Br. 8 n.2. In lead compound cases, the court
    first determines whether a person of ordinary skill in the
    art “would have selected the asserted prior art compounds
    as lead compounds, or starting points, for further develop-
    ment efforts.” See Otsuka Pharm. Co. v. Sandoz, Inc.,
    
    678 F.3d 1280
    , 1291–92 (Fed. Cir. 2012). This requires the
    patent challenger to show by clear and convincing evidence
    that a person of ordinary skill “would have had a reason to
    select a proposed lead compound or compounds over other
    compounds in the prior art.” Daiichi Sankyo Co. v. Matrix
    Labs., Ltd., 
    619 F.3d 1346
    , 1354 (Fed. Cir. 2010) (emphasis
    added). The court then determines “whether the prior art
    would have supplied one of ordinary skill in the art with a
    reason or motivation to modify a lead compound to make
    the claimed compound with a reasonable expectation of
    success.” Otsuka, 
    678 F.3d at 1292
    .
    We have applied a similar test in obviousness cases
    where the prior art discloses a range and a claim limitation
    falls within that range, focusing on “whether there would
    NOVARTIS PHARM. v. WEST-WARD PHARM.                       15
    have been a motivation to select the claimed composition
    from the prior art ranges.” Allergan, Inc. v. Sandoz Inc.,
    
    796 F.3d 1293
    , 1305 (Fed. Cir. 2015); see also Galderma
    Labs., L.P. v. Tolmar, Inc., 
    737 F.3d 731
    , 737–38 (Fed. Cir.
    2013) (“The relevant dispute in this case is thus not over
    whether the prior art discloses all of the claim elements or
    over the motivation to combine the prior art references. Ra-
    ther, the dispute is whether there was motivation to select
    the claimed 0.3% adapalene composition in the disclosed
    range.”).
    The ’131 patent claims methods of using everolimus to
    inhibit growth of solid tumors, including in patients having
    advanced RCC. ’131 patent col. 17 l. 42–col. 18 l. 29. It
    does not claim the everolimus compound itself, but rather
    methods of using the compound. This case therefore does
    not require lead compound analysis or analysis of whether
    a particular dose in a range of prior art doses would have
    been obvious. The district court, however, appeared to ap-
    ply or conflate the standard for these types of cases by re-
    quiring clear and convincing evidence that a person of
    ordinary skill “would have been motivated to select everoli-
    mus.” Decision, 287 F. Supp. 3d at 516 (emphasis added).
    To the extent the district court required a showing that a
    person of ordinary skill would have selected everolimus
    over other prior art compounds, it erred. The proper in-
    quiry is whether a person of ordinary skill would have been
    motivated to modify the prior art disclosing use of temsiro-
    limus to treat advanced RCC with the prior art disclosing
    everolimus. This question was answered affirmatively
    when the district court found that a person of ordinary skill
    “would have been motivated to pursue everolimus as one of
    several potential treatment options for advanced solid tu-
    mors, including advanced RCC.” Id.
    B. Reasonable Expectation of Success
    West-Ward also challenges the district court’s finding
    that a person of ordinary skill would not have had a
    16                    NOVARTIS PHARM. v. WEST-WARD PHARM.
    reasonable expectation of success in using everolimus to
    treat advanced RCC. See Appellant Br. 40–41. It argues
    that the district court erred by imposing “a heightened
    standard under which it found no reasonable expectation
    of success simply because there was not yet clinical proof
    that everolimus would successfully treat advanced RCC.”
    Id. at 41. By February 2001, the prior art disclosed that:
    (1) RCC patients had shown responses to temsirolimus
    treatment in phase I clinical trials (Hidalgo 2000,
    Hutchinson), (2) everolimus was an mTOR inhibitor that
    was available in oral formulations (’772 patent, ’973 pa-
    tent), and (3) inhibiting mTOR in prostate cancer cells in-
    hibits HIF-1, which was hypothesized to inhibit tumor-
    promoting angiogenesis (Zhong 2000). According to West-
    Ward, these disclosures would have provided a person of
    ordinary skill with a reasonable expectation that inhibiting
    mTOR would inhibit growth of advanced RCC, and the dis-
    trict court clearly erred by finding otherwise. See id. at 49–
    55.
    Novartis counters and points out that by Febru-
    ary 2001, there were no clinical trial data on everolimus as
    an anti-cancer agent, and no clinical trials for cancer had
    been completed for mTOR inhibitors. See Appellee Br. 21.
    It further argues that the district court correctly recognized
    the limitations of the temsirolimus phase I data. Id. at 24.
    It also notes the high failure rate of cancer drugs in phase
    II and phase III clinical trials, the numerous failed at-
    tempts to treat advanced RCC, and the pharmacological
    differences between everolimus and temsirolimus. See id.
    at 24–26. Novartis further argues that the district court
    correctly found that the roles of HIF-1 and mTOR in the
    molecular biology of advanced RCC were not completely
    understood. See id. at 43–47.
    We conclude that the district court did not clearly err
    in finding that West-Ward’s asserted prior art combina-
    tion—Hidalgo 2000 or Hutchinson in view of the ’772 pa-
    tent or ’973 patent in view of the knowledge in the art—
    NOVARTIS PHARM. v. WEST-WARD PHARM.                        17
    failed to provide clear and convincing evidence of a reason-
    able expectation of success. In reaching this finding, the
    district court relied on the prior art and expert testimony
    to support subsidiary findings that (1) the temsirolimus
    phase I data had diminished weight, (2) everolimus and
    temsirolimus had different pharmacological properties,
    and (3) the molecular biology of advanced RCC was not
    completely understood. Decision, 287 F. Supp. 3d at 515–
    17.
    The district court correctly recognized that the temsiro-
    limus phase I data resulted from small sample sizes and
    came from studies that were designed to test safety, not
    efficacy. Id. It also noted that the studies disclosed in Hi-
    dalgo 2000 and Hutchinson do not reveal the total number
    of advanced RCC patients enrolled and that phase II data
    was not yet available. Id. Further, it considered the testi-
    mony of West-Ward’s expert Dr. Cho, who stated that a
    person of ordinary skill “would not make a determination
    or reasonable suggestion simply based in isolation upon
    whether a drug enters phase II,” and who did not dispute
    that more than seventy percent of oncology drugs failed at
    phase II. Id. (citing J.A. 1072 at 202:7–15); J.A. 1072 at
    202:7–20.
    The district court also considered evidence that evero-
    limus and temsirolimus are pharmacologically different.
    Decision, 287 F. Supp. 3d at 515–17. Novartis’s expert, Dr.
    Burris, testified that the prior art, which disclosed that ra-
    pamycin and everolimus had different binding affinities for
    FKBP-12, would not have led a person of ordinary skill to
    reasonably expect that rapamycin, temsirolimus, and
    everolimus would all have the same antitumor efficacy.
    See J.A. 1394–95 at 524:2–525:6. Dr. Burris further testi-
    fied that everolimus and temsirolimus had different elimi-
    nation half-lives and that a person of ordinary skill would
    not have expected compounds with different half-lives to
    have the same anti-tumor efficacy. See J.A. 1397–1400 at
    18                    NOVARTIS PHARM. v. WEST-WARD PHARM.
    527:4–530:17. The district court did not err in crediting Dr.
    Burris’s testimony.
    In addition, the district court considered several prior
    art references in finding that the roles of HIF-1 and mTOR
    in the molecular biology of advanced RCC were not fully
    understood as of February 2001.               See Decision,
    287 F. Supp. 3d at 511–14. The district court cited Se-
    menza, which showed that numerous pathways are impli-
    cated in HIF-1 activation in human cancers. Id. at 512; see
    J.A. 2128. Semenza states that “the role of HIF-1α expres-
    sion in [RCC] requires further analysis.” J.A. 2119. The
    district court also cited to Alexandre, 8 which noted that
    “there is still much to learn on, firstly, the exact mecha-
    nisms by which mTOR controls the G1/S transition and,
    secondly, on any other cellular targets of rapamycin.” De-
    cision, 287 F. Supp. 3d at 512 (quoting J.A. 1978). It fur-
    ther recognized Zhong 2000, which cautioned that
    “[a]dditional studies are required to determine whether
    this process is modulated by PI3K/AKT/[mTOR] activity
    and, if so, whether such modulation involves direct phos-
    phorylation of HIF-1α.” Id. at 513; see also J.A. 2194. In
    addition, the district court noted Sekulić, 9 which states
    “[c]learly, additional experiments are required to establish
    the relationship between deregulated PI3K-AKT activity
    and rapamycin sensitivity in human cancer cells.” Deci-
    sion, 287 F. Supp. 3d at 513 (quoting J.A. 2105).
    The district court’s finding is also consistent with rec-
    ord evidence explaining that inhibiting mTOR does not
    8  Jérôme Alexandre et al., Rapamycin and CCI-779,
    86 Bull. Cancer 808, 808–11 (1999).
    9   Aleksandar Sekulić et al., A Direct Linkage Be-
    tween the Phosphoinositide 3-Kinase-AKT Signaling Path-
    way and the Mammalian Target of Rapamycin in Mitogen-
    stimulated and Transformed Cells, 60 Cancer Res. 3504,
    3504–13 (2000).
    NOVARTIS PHARM. v. WEST-WARD PHARM.                        19
    necessarily result in tumor growth inhibition.          Hi-
    dalgo 2000 states that “a critical issue is whether these
    downstream effects [of mTOR inhibition] correlate with the
    anti-tumor activity of [temsirolimus], particularly since
    malignant cells can traverse the cell cycle and proliferate
    despite the [downstream effects of mTOR inhibition] by ra-
    pamycin.” J.A. 2032. Dr. Burris explained that in this
    quote, Dr. Hidalgo was “pointing out that even when think-
    ing that we were inhibiting the mTOR pathway, we could
    still see tumor cells traverse, continue to grow and prolif-
    erate.” J.A. 1337–38 at 467:19–468:2. In addition, Dr. Cho
    testified that mTOR inhibition does not necessarily mean
    that tumor growth will be inhibited. See J.A. 1108
    at 238:19–24 (“Q: But you agree that a POSA would under-
    stand that you can have mTOR inhibition and still see tu-
    mor growth; right? A: A POSA would have been aware that
    that is possible.”).
    We discern no clear error with the district court’s find-
    ings. We also disagree with West-Ward’s contention that
    the district court applied an erroneously heightened stand-
    ard in its analysis. The district court reviewed the above
    evidence, determined that the molecular biology of ad-
    vanced RCC was not fully understood, recognized the limi-
    tations in the temsirolimus phase I data, and found that
    such data did not provide a person of ordinary skill with a
    reasonable expectation of success. Decision, 287 F. Supp.
    3d at 515–17. We hold that the district court did not err in
    its determination and affirm its conclusion that claims 1–3
    of the ’131 patent would not have been obvious in view of
    the asserted prior art.
    CONCLUSION
    We have considered West-Ward’s remaining argu-
    ments and find them unpersuasive. While the district
    court erred in its motivation to combine analysis, this error
    is harmless as the district court did not clearly err in its
    finding regarding reasonable expectation of success. For
    20                    NOVARTIS PHARM. v. WEST-WARD PHARM.
    the reasons above, we affirm the district court’s decision
    that West-Ward failed to prove by clear and convincing ev-
    idence that claims 1–3 of the ’131 patent are invalid as ob-
    vious.
    AFFIRMED